community pharmacy

This blog by Mark Robinson discusses why pharmacy is at the heart of healthy living in communities – and explains how pharmacists can play a wider role in supporting the objectives of the new Health Creation Manifesto
The NHS Alliance has consistently said that community pharmacy is an under-utilised asset within the NHS family. They are the front line professional clinical retail element of healthcare – and the focus of self-care for the population – representing ‘health on the high street’ and within our communities.
Our view has been that the health and care system has needed to better recognise the vital part that the nation’s community pharmacists play in improving the care of patients and in helping people to stay healthy and we have argued strongly for a greater role for pharmacy within primary care.
Our advocacy for the value of community pharmacy – and it’s importance as a hub for healthy communities – is now further amplified in our “A Health Creation Manifesto” – launched in May 2017. This groundbreaking and visionary manifesto sets out 10 high impact recommendations to create a wellness-based health system, aimed at tackling the root causes of ill health and the continuing problem and social injustice of health inequalities. Health creation is an evidence-based approach that is about putting people in control of their own lives and we have developed a deep experience of actually making it work.
The essence of this health creation approach is based on ‘3 Cs’:

control over the circumstances of our own lives

contact with other people that is meaningful and constructive

confidence to see ourselves as an asset

We have to create the conditions for people to increase their confidence, to connect with others and their families, to give them hope and empower them. We have to help to put them in control of their well-being. We have to do things that will help them feel well. And crucially, we have to show them that they can do it themselves and they don’t need the constant attention of their doctor. People don’t need a pill for wellness!
This is where the community pharmacy sector is a crucial and dynamic resource for supporting health creation and wellness, because community pharmacies are not just accessible geographically, they are also accessible psychologically. People aren’t intimidated going into a pharmacy and talking to a pharmacist – and that, in part, is because their local pharmacy’s focus is also on health and wellbeing, rather than solely on sickness. What’s more, the staff in a pharmacy are invariably drawn from the local community and therefore they often know many people within the neighbourhood. That sense of familiarity actually gives a real and tangible sense of confidence and trust to the local people coming into their local pharmacy.
The New NHS Alliance would now like to see a natural evolution from healthy living pharmacies to health creating pharmacies, and for community pharmacists to welcome and embrace the opportunity to provide their local communities with advice and support on health creation, health creating services and initiatives to encourage a sense of physical, emotional and mental wellbeing.
New NHS Alliance has seen many excellent examples of innovative community pharmacy involvement in health creation around the country. One such example, cited in our Manifesto, involved community action in reducing GP appointments. Community groups and residents in Eccles learned about the Minor Ailments Scheme and were encouraged to tell other residents to visit the local pharmacy before the GP. Children, parents and clinicians co-wrote a story that was read out at the local school – teaching children to steer family members to the pharmacy.
The scheme had support from seven local general practices. In six months, pharmacy consultations rose from around 250 a month to more than 350. There were also signs that fewer parents went to the GP for minor ailments, with a sharp decline in surgeries prescribing paediatric paracetamol and ibuprofen.
New NHS Alliance contend that only by forming strong relationships and listening to communities can we address the ’causes of the causes’ of ill-health and for community-led solutions to be found. So let us maximise the skills and expertise that community pharmacists bring to health creation – and make our local pharmacies a vibrant and proactive hub for health creating local communities!Mark Robinson is a pharmacist with extensive experience within the NHS – and is the New NHS Alliance National Executive Lead on Pharmacy.

It has been an extraordinary privilege to lead NHS Alliance alongside Michael Dixon. I had no plans to become a chief executive again but Michael is a difficult man to say no to, and the opportunity to work alongside him and the extended family of the NHS Alliance was impossible to resist. So, as we hand over to a new leadership team, I would like to offer a few quick reflections on how far we have come over the last four years. I came in at a difficult point when the Alliance was facing an uncertain future. So what did we do?First, we successfully shifted the focus from clinical commissioning to primary care provision. The NHS Alliance has always enjoyed taking the moral high ground – and giving away our core membership to help create NHS Clinical Commissioners was the right thing to do but, raised serious questions about the purpose and future of NHS Alliance. It was increasingly clear to us that how providers work together – including how general practice works at scale and works with the rest of the wider community – would be central to our future mission.Second, to support this we needed to overhaul the way we worked. Today is a key milestone in this journey, but NHS alliance has already become increasingly virtual, without an office base. We also took steps to reduce our costs, establishing new partnerships and build on our strengths – bringing together leaders across primary care who are passionate about using their experience and expertise to make a difference, connecting what happens on the front line with policymaking in Whitehall.Third, we needed to be clear about who we were and what we believed in. We have published two major statements of our values and aspirations. Our Manifesto for Primary Care ‘Breaking Boundaries’ and towards the end of last year, just before the FYFV, our own ‘Think Big, Act Now: Creating Communities of Care.’ We continue to produce ground breaking work, including ‘Pharmacists & General Practice’ that has shaped the rapid growth of practice pharmacists, our work on tackling the current recruitment crisis by creating a new role for practice pharmacists, working with Pharmacy Voice on, ‘We are Primary Care’. And finally, bridging the gap between health and housing including ‘Housing: Just what the doctor ordered’ and most recently our work ‘Making Time in General Practice’ leveraging significant changes from the Secretary of State.Finally, we have built and developed a new team to lead NHS Alliance, bringing together a new generation of leaders for primary care. We have welcomed not just bright new stars from general practice but leaders from across the breath of primary care and the wider community; from housing, fire and rescue, community development and the police. And, today is the culmination of this process, making way for a new leadership team.
This is also an opportunity to remind ourselves of what is so special about NHS Alliance. In the end, it is always the people, the connections and the relationships. We manage to achieve a lot together and I have no doubt that the future will be every bit as impressive in the hands of the new leadership team. Personally, I am looking forward to shifting back to being part of the team, as before, rather than leading it as we continue to make the case for health and well being across our communities.Rick SternOutgoing Chief Executive, NHS Alliance